Helping someone you think may be self-harming

From a local ‘expert by experience’ (parent of someone who self harms)

Witnessing the signs of someone else's self-harm can be very difficult and distressing however it's important to overcome this instinctive reaction and recognise that the person is struggling and in need of help.

Start a conversation

Having the courage and confidence to approach someone who self-harms and offer support could make an enormous difference to them.  However, before approaching them you should also take the time to think about your own feelings about self-harm, so they don’t get in the way of your conversation.  If you feel unable to talk to the person yourself try to find someone else who can talk to them.

By starting a conversation you could give them the opportunity to open up or at least consider doing so.  So how can you start the conversation when it may feel incredibly awkward and challenging to broach such a subject? 

Some phrases you could use are:

‘Sometimes, when people are in a lot of emotional pain they may hurt themselves to cope.  Is that how your injury happened?'

‘I’ve noticed your injury/marks/scars and I just want to check whether you are getting any support or whether you are in need of help?'

‘I am here if you want to talk or I can show you where you can get some help if you don’t feel comfortable talking to me.'

Take the time to listen

Remember to listen with empathy and communicate non-judgementally. Feelings of shame and fear of judgement from others cause people who self-harm to hide their scars and marks and therefore push their troubles further within themselves. Don't blame the person for their difficulties - though their self-harm may be difficult to understand from your perspective, it may be the only way they know how to cope at the present time. Blaming or shaming the person is more likely to reinforce the cycle of distressing emotions which often underlie self-harm.

Don't try to solve the problem right away

Quite often when you’re wanting to help someone you can try to problem solve and offer solutions.  Someone who self-harms needs space and time to open up, so rather than saying things like ‘it will be ok, don’t worry, don’t be silly, things will get better’, reflect what the person is saying by acknowledging their experience as they are describing it.  It is possible to acknowledge another person’s emotional experience without necessarily agreeing with all their actions.  Tell them that you care and want to help.  Let them know that alternative strategies for coping can be learnt when they are ready, that support is available and that they are not alone.

Support them in getting help

Self-harm is often a sign of an underlying mental health issue so encourage the person to seek professional help. The first source of professional help will usually be the person's GP. If the person doesn't want to seek professional help, try to explore their reasons for this. They may be afraid of stigma or may have had negative experiences previously when they have tried to access help related to their self-harm. Explore options such as seeking a second opinion, or seeking help from alternative sources such as voluntary sector organisations focusing on supporting those affected by self-harm.

Let them know you are there for them

Bear in mind that not everybody who self-harms wants to change their behaviour.  In this case, make it clear to them that they are welcome to return to you for support in accessing help if and when they are ready.  Be honest about the fact that you may not be able to keep their self-harm a secret and may need to seek help if you are concerned about the seriousness of their injuries, but explain that you will try to speak to them first where possible.

Whatever the outcome of your conversation the most important thing is that you have recognised someone else’s difficulties and distress and created an opportunity for them to seek and accept help.